On May 14, Dr. Keith Ablow, a Fox News contributor and practicing psychiatrist, posted comments on the Fox News website about the American Psychiatric Association and its current revision of the Diagnostic Statistical Manual. 

The DSM was created in 1952 to provide a complete and reliable source of diagnostic categories and descriptions of mental disorders. its formation was guided by two fundamental principles; that the diagnostic categories and criteria that define mental disorders, are supported by substantial scientific evidence, and that they are consistent with public health needs. the DSM is periodically revised to update diagnoses and their defining criteria as new knowledge is generated. the last revision to the DSM was in 1994.

In his article, Ablow made comments about the APA and DSM-V, which I believe are inaccurate and unsubstantiated by scientific evidence. Moreover, they are misleading to the public and potentially harmful in that by undermining the credibility of the psychiatric profession and its scientific underpinnings. they may even deter people in need from seeking treatment.

For this reason, I offer the following comments in response. I believe that I am qualified to do so as Professor and Chair of Psychiatry at Columbia University College of Physicians and Surgeons and the President Elect of the APA.

It is one thing to have a distressing and disabling psychiatric condition that affects one’s perception, cognition and emotions, and impairs quality of life, relationships and well-being.  but it is quite another level of tragedy when that condition goes undiagnosed, or when one is unable to get access to treatment because of stigma and shame or a lack of insurance coverage.  Relief from symptoms and recovery may be postponed or may never happen.  the consequences are not just inconvenience – as with any serious non-psychiatric medical condition, they are real, life-altering and potentially life-threatening.

For decades, the APA has worked diligently to provide definition in the environment of mental health through the development of the Diagnostic and Statistical Manual of Mental Disorders.  since DSM-III, each edition has provided evidence-based guidance in manual form for use by clinicians and researchers to diagnose and classify mental disorders so that patients in need can be effectively evaluated and gain access to treatments.

Since DSM-IV was released in 1994, there has been a wealth of new research and knowledge about the nature and frequency of mental disorders, how the brain functions and its neurobiology, and the lifelong influences of genes and environment on a person’s health and behavior.  Accordingly, the newest edition – DSM-V – will reflect that new body of knowledge.  And people who now suffer from a range of conditions will be the beneficiaries as they become increasingly likely to get an accurate diagnosis and access to treatment for it.

Many of the changes that are being proposed for this new edition were done to better characterize symptoms and behaviors of groups of people who are currently seeking clinical help but are less well-defined under the guidelines of the current DSM-IV edition.  the hope is that by more accurately defining disorders, diagnosis and clinical care will be improved and new research will be facilitated to help improve our understanding.  

The APA recognizes the importance not only of the document, but of the process for creating it and takes this responsibility with the utmost seriousness and as a sacred trust. Contrary to Ablow’s comments, the process for revision is not arbitrary and not politicized.  

For this revision, the APA recruited more than 160 of the top researchers and clinicians from around the world to be members of the DSM-V Task Force, Work Groups and Study Groups.  

These experts in neuroscience, biology, genetics, statistics, epidemiology, social and behavioral sciences, and public health were rigorously vetted for any conflict of interest using guidelines derived from other academic professional organizations and from the federal government itself and have worked assiduously for over five years to scour the scientific literature and determine whether any changes to existing DSM-4 diagnoses and additions were warranted.  they participated on a strictly voluntary basis and come from several medical and health care disciplines including psychiatry, psychology, pediatrics, nursing and social work.

The definition of mental illnesses may at times be a matter of debate – and they should be.  but the importance of mental illness and the need to recognize and diagnose it cannot be understated.  Without them, diagnostic approaches could vary widely.  the treatment of conditions would be uneven.  Payment for services would be difficult, to say the least.

For too long in human history, persons with mental illness were feared, persecuted or ignored. Stigma of mental illness in our society was pervasive. 

However, through biomedical research and enhancement of public awareness we have made great strides in the U.S. to establish a strong scientific basis for our understanding of human behavior and brain disorders that affect mental functions and bring them out of the shadows so that people can recognize symptoms and seek treatment. 

That is why the APA has gone to great lengths, and taken great care, from every angle, to produce a document that incorporates new knowledge to develop the latest guidelines that will benefit practitioners and patients alike.

Dr. Jeffrey Lieberman is the chairman of Department of Psychiatry at Columbia University College of Physicians and Surgeons, and director at the New York State Psychiatric Institute.

Free research paper example on Hepatitis C:

Introduction:Everyone knows that when they feel sick, that something is not right, they should see a doctor. But what if you could not tell if you are sick, in fact, sick with a virus that will soon enough cause more deaths than AIDS. for twenty years, you could be hosting a virus without even knowing, until it is too late. you begin to feel a fever, chills, headache, fatigue, and muscle aches, these symptoms are flu-like, but what you may be really experiencing are the symptoms of Hepatitis C.

Central idea:Hepatitis C is an epidemic for anyone, of all walks of life and by 2010, the death rates will most likely surpass AIDS.

Credibility and Goodwill: I have always heard of Hepatitis C and never really understood what it could do to somebody, all I remember was being told not to touch someone’s blood. AIDS were always the big topic of diseases in school because it is such an epidemic. I did not have one concern of Hepatitis C until one day my dad came home and broke the news. he said that there is a possibility that he may have Hepatitis C; it is not a certainty, but a good possibility.

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I was wondering how my dad could contract Hepatitis C, because I was never educated on the topic and was clueless. he told me not to use anything of his, no matter what it was, for he feared that I may get it. the good news is that two weeks later after a second tests, the doctors found that there was a flaw in the first diagnosis. At my job RHM & Assoc., we conducted a survey to interview Hepatitis C patients taking an interferon for treatment, I have spoken to over fifty who have told me how they got it, what it feels like, and how grateful they are for being alive.this freaked me out, that within 6 months hepatitis C seemed to be a popular issue, at least around me. I was curious as to how to defend myself from this epidemic and to educate all of you how to simply be careful with what you are doing.

Preview: I will tell you what Hepatitis C is and what it can do to you. I will also tell you the treatments for Hepatitis C and how to avoid it.

(Transition: Let’s start with, “What is Hepatitis C anyway?”)

Body: 1. Hepatitis C is a virus, and like all virus, there is no way to vanish the virus from your body. for instance Herpes, once you have it, you are stuck with it. There are at least six viruses known to cause liver disease: hepatitis A, B, C, D, E, and G, which vary in their severity and characteristics. Hepatitis C can lead to serious, permanent liver damage, and in many cases, death.

Hepatitis attacks only the liver, because many viruses only attack certain cells, like pneumonia – it only attacks the human lungs. it causes some flu-like symptoms for a short period of days; so many victims are unaware that they are experiencing the effects of Hepatitis C, because they pass it off as the flu. In the beginning of the attack of Hepatitis C, it is referred to as acute hepatitis C. But it begins to slowly worsen to chronic Hepatitis where the symptoms are so severe that a liver transplant is needed. according to John Henkel of the U.S. Food and Drug Administration, “Hepatitis C is the major reason for liver transplants in the United States, accounting for 1,000 of the procedures annually. the disease is responsible for between 8,000 and 10,000 deaths yearly.”Those with acute Hepatitis C have a 75% chance of developing chronic hepatitis C.|

Hepatitis C was not discovered until 1989, but the patients whom I have spoke with mentioned contracting the disease in the early 80’s. this means that most of the people that I have spoken with has chronic Hepatitis. most of them sounded horrible, they were so restless, and it was if I was speaking to someone in their death bed, this is primarily due to the interferon treatment.

2. the treatment to clear the virus is like going through hell. the two treatments of interferon I was to interview the Hepatitis patients on were, Pegasys and Peg-Intron. we interviewed to find out what was better, which one had less side effects, because the two were made by to separate companies. My job requires me not to speak of actual results for each interferon, but they were very close with satisfaction. I have been praised for working for such a company that made this wonder drug, and I have been screamed at for working for a drug that is “killing my wife.” Here is the story; I am supposed to speak to the patient and patient only for confidentiality reasons. the husband answered and knew immediately who I was because the patients were asked months ago to participate. he said that this drug was destroying his wife and making her worse. What this man failed to realize was that these were the effects of the drug.

Patients may face any of these symptoms from the treatment: aches and pains in muscles or joints, anemia, decreased appetite, autoimmune problems, bleeding gums, brain fog, the flu, depression, problems with digestion, dry mouth, taste changes, fatigue, hair loss, head aches, insomnia, menstrual problems, diarrhea and nausea, rage, rashes, shortness of breath, and the list goes on. I actually had to ask people on a rated scale the effects of most of these during treatment, and it varied from person to person, really just how lucky you are.

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